Light exposure at night and sleep quality in bipolar disorder: The APPLE cohort study

Yuichi Esaki, Tsuyoshi Kitajima, Kenji Obayashi, Keigo Saeki, Kiyoshi Fujita, Nakao Iwata

Research output: Contribution to journalArticle

Abstract

Background: Sleep disturbance in bipolar disorder (BD) is common and is associated with a risk for mood episode recurrence. Thus, it is important to identify factors that are related to sleep disturbance in BD. This cross-sectional study investigated the association between exposure to light at night (LAN) and sleep parameters in patients with BD. Methods: The sleep parameters of 175 outpatients with BD were recorded using actigraphy at their homes for seven consecutive nights and were evaluated using the Insomnia Severity Index (ISI). The average LAN intensity in the bedroom during bedtime and rising time was measured using a portable photometer, and the participants were divided into two groups: “Light” (≥5 lx) and “Dark” (<5 lx). The association between LAN and sleep parameters was tested with multivariable analysis by adjusting for potential confounder such as age, gender, current smoker, mood state, day length, daytime light exposure, and sedative medications. Results: After adjusting for potential confounder, the actigraphy sleep parameters showed significantly lower sleep efficiency (mean, 80.1%vs. 83.4%; p = 0.01), longer log-transformed sleep onset latency (2.9 vs. 2.6 min; p = 0.01), and greater wake after sleep onset (51.4 vs. 41.6 min; p = 0.02) in the Light group than in the Dark group. Whereas, there were no significant differences in the ISI scores between the groups. Limitations: This was a cross-sectional study; therefore, the results do not necessarily imply that LAN causes sleep disturbance. Conclusions: Reducing LAN exposure may contribute to improved sleep quality in patients with BD.

Original languageEnglish
Pages (from-to)314-320
Number of pages7
JournalJournal of Affective Disorders
Volume257
DOIs
Publication statusPublished - 01-10-2019

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Bipolar Disorder
Sleep
Cohort Studies
Light
Actigraphy
Sleep Initiation and Maintenance Disorders
Cross-Sectional Studies
Hypnotics and Sedatives
Outpatients
Recurrence

All Science Journal Classification (ASJC) codes

  • Clinical Psychology
  • Psychiatry and Mental health

Cite this

Esaki, Yuichi ; Kitajima, Tsuyoshi ; Obayashi, Kenji ; Saeki, Keigo ; Fujita, Kiyoshi ; Iwata, Nakao. / Light exposure at night and sleep quality in bipolar disorder : The APPLE cohort study. In: Journal of Affective Disorders. 2019 ; Vol. 257. pp. 314-320.
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abstract = "Background: Sleep disturbance in bipolar disorder (BD) is common and is associated with a risk for mood episode recurrence. Thus, it is important to identify factors that are related to sleep disturbance in BD. This cross-sectional study investigated the association between exposure to light at night (LAN) and sleep parameters in patients with BD. Methods: The sleep parameters of 175 outpatients with BD were recorded using actigraphy at their homes for seven consecutive nights and were evaluated using the Insomnia Severity Index (ISI). The average LAN intensity in the bedroom during bedtime and rising time was measured using a portable photometer, and the participants were divided into two groups: “Light” (≥5 lx) and “Dark” (<5 lx). The association between LAN and sleep parameters was tested with multivariable analysis by adjusting for potential confounder such as age, gender, current smoker, mood state, day length, daytime light exposure, and sedative medications. Results: After adjusting for potential confounder, the actigraphy sleep parameters showed significantly lower sleep efficiency (mean, 80.1{\%}vs. 83.4{\%}; p = 0.01), longer log-transformed sleep onset latency (2.9 vs. 2.6 min; p = 0.01), and greater wake after sleep onset (51.4 vs. 41.6 min; p = 0.02) in the Light group than in the Dark group. Whereas, there were no significant differences in the ISI scores between the groups. Limitations: This was a cross-sectional study; therefore, the results do not necessarily imply that LAN causes sleep disturbance. Conclusions: Reducing LAN exposure may contribute to improved sleep quality in patients with BD.",
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Light exposure at night and sleep quality in bipolar disorder : The APPLE cohort study. / Esaki, Yuichi; Kitajima, Tsuyoshi; Obayashi, Kenji; Saeki, Keigo; Fujita, Kiyoshi; Iwata, Nakao.

In: Journal of Affective Disorders, Vol. 257, 01.10.2019, p. 314-320.

Research output: Contribution to journalArticle

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